HVS consists of a multitude of somatic symptoms (dizziness, discomfort, difficulty breathing, tingling, stiffness of the tongue and mouth, impaired vision, loss of consciousness or presyncope, tremors, palpitations, bloating of the stomach, hand cramps) induced by hyperventilation (of which the patient is not generally aware) and reproducible at least partially by voluntary hyperventilation.
It is a common syndrome, often associated with a mood disorder (anxiety). The HVS is frequent in general medicine, neurology, pneumology and cardiology. Often patients with HVS consult the neurologist with the fear of a brain disease such as multiple sclerosis (after searching on the internet a cause for their symptoms)
The diagnosis is clinical using specific questionnaires (Nijmegen) and the hyperventilation test, as well as a detailed somatic and psychic history. Neurological examination is normal.
Benzodiazepines and SSRI drugs can be effective, but temporarily, and there are not the final solution. Breathing in a plastic bag is no more recommended.
The education of the patient who should learn exactly what she/he has and the mechanisms involved is fundamental and probably the most effective therapeutic act. Learning breathing techniques without or with feedback (reducing the respiratory rate and promoting relaxation) is important and it is the most appropriate therapeutic approach together with psychotherapy. Any other (non-pharmacological) approach to controlling anxiety and promoting relaxation should be encouraged (yoga, acupuncture, manual medicine, meditation, mindfulness).